“Nine Elms” presumably refers to the London suburb or lane. The 3rd Australian and 44th Casualty Clearing Stations were based here, No. 3 A.C.C.S. from October 1917 to April 1918.
Towards the end of August we were shelled out of Brandhoek several casualties among the personnel being sustained. Out [our] next site was Nine Elms close to Poperinghe. The Unit was attached temporarily to No.10 C.C.S. [Remy Siding?, Sheet 28 L22 d6.3] while reorganising after Brandhoek. The close of 1917 saw us still under canvas at Nine Elms, where we spent the winter and remained until April 1918 when we were forced by the German advance to retreat in good order to Esquelbecq some twenty miles further back. For the week prior to our departure the Germany long range guns were dropping shells perilously close to the camp every day.
‘Early History,’ War Diary, April—May 1919
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Map courtesy GWF member mebu
3 A.C.C.S. location according to War Diary “Sheet 27 L10 B3.5”. Based on trench map location and aerial photo below (showing 5 large structures together), the Australian hospital is likely the easterly of the two Casualty Clearing Stations.
Sister May Tilton was with No. 3 A.C.C.C.S. at Nine Elms from 4 October 1917 to December 1917.
Aerial photo of 3 A.C.C.S. at Nine Elms. War Diary, March 1918.
The following morning, we were recalled. The advance up the line resulted in a heavy toll of victims, and patients were admitted before the hospital was properly equipped and ready. It was pouring with rain, making conditions bad for the men in the line, and worse for the wounded who lay out in it, sometimes for days.
Patients began to arrive at 11 a.m., and in the first twenty-four hours about three thousand patients passed through our C.C.S. We admitted for twenty-four hours at a time in turn with the other C.C.S. alongside us. Hospital trains stood by and carried the wounded away as fast as we could get them ready. Only the worst cases could we possibly hope to attend to.
The work in the Resuscitation ward was indescribable. The butchery of these precious lives— men of such splendid physique! To watch them dying in such numbers was ghastly. Their frightful condition was appalling: clothes saturated; faces caked with mud; the conscious ones smiling grimly, glad to be wounded and out of it. It was after midnight when matron insisted on the day staff going to bed for a few hours’ rest. The orderlies refused to go to bed. Matron (Miss O’Dwyer) herself rarely, if ever, went to bed before the early hours. She watched over her staff; or would be found writing letters to the relatives of the “dangerously ill,” or to those whose loved ones had passed away—a colossal task.
On the way to our quarters, I met Sister Soden, groping her way along the duckboards in the dark. The way was strange to us both, and it still rained heavens hard. We slipped into an empty ward, as we thought, and tripped over a stretcher in the dark. When we switched on our torches, we found the floor literally covered with a mass of wounded; men being sick, moaning in pain, or crying out for a drink; pleading to remove their boots which, in some cases, had not been off their feet for over a week. The stretcher-bearers were carrying them in out of the pouring rain and rushing away again. We set to work, lifting the stretchers into some sort of order and searching for cases of haemorrhage, while the wounded held the torches to guide us.
As the bearers brought in patients, we lifted stretchers out ready for them to carry away again the urgent cases requiring immediate surgical attention. It was bending work, and when our backs refused to hold us up any longer, we sat on the floor and cut the boots and socks off the stone-cold and swollen feet, wrapping them in bundles of cotton wool and bandages. The patients used their boots or tin hats as pillows while they patiently and uncomplainingly waited to be attended to. While I attended one poor boy who had begun to haemorrhage, the next patient, sitting up, commenced coughing and spluttering. I turned my torch on him, revealing a German bleeding profusely from a horribly shattered lower jaw. Both men were immediately carried out into the rain again for the operating theatre. There was an understood arrangement in all hospitals that all Germans (except urgent cases) should wait for attention till all the British patients had been attended to for operations, dressings or food. This rule, of course, was not strictly adhered to; less serious cases of British soldiers were often kept waiting while the more seriously wounded Germans were treated and cared for.
Matron and an orderly appeared together, with a lighting apparatus for the ward. When she saw us, she took hold of us both and pushed us out of the ward, saying she probably would need us back in two or three hours, and we must have some rest if we were to carry on.
The privacy of our tents was a welcome relief for the weakness we dared not show before our brave, suffering boys.
Each morning the Resuscitation ward was full of almost all new cases. The night sister said they were being carried out to be buried all night long:
“I cannot speak of it,” she said. “I feel I want to scream and scream.”
The attack was still going on up the line. The guns were roaring incessantly, and 5.9 shells screamed over our heads, continuing the destruction of Poperinghe. We hated and dreaded the days that followed this incessant thundering, when the torn, bleeding, pitifully broken human beings were brought in, their eyes filled with horror and pain; those who could walk staggering dumbly, pitifully, in the wrong direction. Days later men were carried in who had been found lying in shell-holes, starved, cold, and pulseless, but, by some miracle, still alive. Many died of exposure and the dreaded gas gangrene.
One day a Jock was brought to us, unconscious, pulseless, and stone cold, yet still alive, after lying in the rain for hours with a piece of shrapnel in his abdomen. For hours our efforts to thaw him seemed hopeless. The M.O. said he “couldn’t make it.” But where there was life there was hope, and we won. His resurrection was miraculous. When his pulse came to life he was hastened to the theatre. The operation proving successful, he was comfortably bedded in one of the acute surgicals. It was a struggle to hang on to life, but at the end of three days he looked like making a success of it. I anxiously watched his progress each day. On the fourth morning, when I visited him, I said:
“Don’t feel like smiling yet, Jock? Why?”
“No, sister, I doan’t feel like it. I’ve had nothing to eat for three days, and that’s why.”
“Well, we’ve been so anxious to keep you alive, laddie, but what about a glass of champagne now? Will that help at all ?”
“Will it what! Try me. An’ Fritz can’t kill me, either, sister. So forgit that, and let’s try that champagne.”
Dr W Page carrying a German propaganda balloon and Captain Evan I Littlejohn, the balloon fell near the 3rd Australian Casualty Clearing Station at Nine Elms, near Poperinghe. AWM A02286
During the first week, matron sent me to work on a team with Captain Spowers. There were twelve operating surgeons, with theatre teams, working on six tables continuously for the twenty-four hours. The theatre staff worked the longest hours; the routine was sixteen hours on and eight off duty. An American, Canadian, and South African team arrived to supplement the staff, and were all on night duty. Two days later the American sister developed an appendix and was returned to the base. I was privileged to take her place.
We went on duty at 8 p.m. and worked continuously during a “stunt,” until the following midday, with ten minutes for supper at midnight, and half an hour for breakfast at 8 a.m. The American surgeon, Captain Philip Wilson, had been working with the French Army since the beginning of the war. Then, when America joined the Allies, he joined up with his own people. He was a wonderfully quick and clever surgeon; the most considerate, placid, even-tempered one I had met in all my experience.
A case of multiple wounds was carried to our table, and life depended on speedy repairs. When he could spare my assistance at the critical work of big wounds, he would say:
“Get on with the minor wounds, sister, or we won’t save this chap.”
I trembled at the knees, for it meant using the scalpel—work I had never done before. When I told him, he replied:
“I could not have a better or more capable assistant than you have proved to he. Forget yourself and think only of our patient.”
So I did, and we saved lots of time.
Captain Wilson commenced giving transfusions of blood, with marked success. The walking wounded would offer their blood to be drained from their veins into those of dying comrades, saving many a life that otherwise would have died. It was fine to see the smiles of gratitude the poor, bloodless one would give his rescuer as they lay side by side, and then to listen to the way the smile would be answered:
“Look out, old chap, you don’t git buck-jumpin’ off that table when they pump this into you,” said a fine, big Canadian. “I’m at home on a buck-jumper. It’s in me blood, an’ you’re gittin’ some of it. Give him plenty, doc. I can spare it, an’ it’s good and healthy.”
Then the joy of watching its beneficial effect. Those who gave their blood were allowed champagne to drink, and eggs and bacon for breakfast—which they thought ample reward—and on their tickets was marked, “Two weeks’ leave in England,” although they never looked for compensation.
During the first month, fifteen hundred operations were performed by our theatre team.
We were having a trying time from air raids one night when we were working at high pressure. Fritz came nosing about overhead, his machine flying so low that he seemed to be just above our tent. Everyone was deathly quiet, staring at each other, not daring to ask what we were thinking. It was an awful strain on the surgeons, with their close and critical work, and no decent sleep for weeks. But they worked on as calmly and quietly as though the menace in the sky did not exist; and when the bombs exploded with a deafening roar, making our heads pound and throb, we breathed a sigh of relief that the operating tent had escaped, and our work could go on.
No. 3 A.C.C.S., Nine Elms, Flanders. October, 1919 [printed in May Tilton, The Grey Battalion – caption seems incorrect, snow in October? Tents still up in 1919?]
1 November. As I was walking along the duckboards between the wards, coming off duty after a heavy night, a “dud” archie fell with terrific force not two yards from me, and buried itself six feet in the ground between the tent ropes. The rush of air, as it fell, knocked me down. Two orderlies, walking behind, thought I had been hit, and rushed to my assistance.
“Jove, that was a close shave, sister!” said one.
“Yes,” I replied, and walked on to my tent, wondering why I had escaped it.
Too dead tired to notice the guns, I ceased to be worried by them. We learned to fit them into the back of our subconscious minds and forget them. They boomed without interval, never a lull in their muffled thunder for days on end. The men who came down said the Germans were counter-attacking. Desperate fighting continued into November until Passchendaele was captured by the Australians.
16 November. Matron (Miss O’Dwyer) was recalled and transferred to a hospital in England, after twelve months of strenuous work on the Somme and in this area. Miss Grace Douglas was sent to relieve her.
Eventually, during December, No. 3 was converted into a convalescent camp.
Excerpts from May Tilton, The Grey Battalion pp258-276
Miss Conyers and myself drove to Nine Elms and inspected No.3 Australian CCS where we saw the OC and discussed the question of teams and he pointed out the necessity of being supplied with a sufficient number of thoroughly efficient theatre Sisters directly the heavy work began. The unit is partly hutted, partly under canvas and the Sisters are extremely well housed in Armstrong huts, their mess and ante-room being in a marquee.
Official war diary of the Matron-in-Chief, British Expeditionary Force, 13 March 1918
Poperinghe, Belgium. A section of the Nine Elms British Cemetery showing the remembrance stone. This cemetery contained 1556 service graves including 149 of members of the AIF. AWM H12646
The cemetery was begun and used by the 3rd Australian and 44th Casualty Clearing Stations when they moved to Poperinghe (now Poperinge), from Brandhoek and Lijssenthoek respectively, in September 1917. Nearly all the burials in Plots I to IX came from these Casualty Clearing Stations, whilst they operated in this area during the 1917 Battle of Ypres, up until December 1917. Plots X, XI, XIII, XIV and XV cover the dates between the beginning of March, 1918 and the 12th October, 1918, the period of the German offensive in Flanders, the British counter attacks and the final advance of August-September. The burials in these cases were carried out almost entirely by fighting units. The cemetery contains 1,556 Commonwealth burials of the First World War and 37 German war graves from this period. There are also 22 Second World War burials in the cemetery, all dating from the Allied retreat to Dunkirk in 1940. The cemetery was designed by Sir Reginald Blomfield.
Commonwealth War Graves Commission
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We're pleased that people are using this website as a source for locations, quotes and other primary source material. It's why we published our notes on the web. But we'd very much appreciate a footnote or credit. Much of the hospital (and other) location information for Lemnos and the Western Front is original research -- thank you, from Bernard & Cheryl